The Shh And Foxm1 Protein’s Expression And Clinical Significance In Gallbladder Carcinoma And Their Relationship To Tumor

Part 1 The Expression and Clinical Significance of Shh and Foxm1 inGallbladder carcinomaObjective: To test the expression of Shh and Foxm1 in Gallbladder carcinoma tissue and chronic cholecystitis tissue, and explore its clinical significance.Methods: 72 cases of GBC tissue, Formalin-fixed and paraffine-embedded, were collected from the First Affiliated Hospital of Nanchang University from January 2008 to June 2014. 60 cases of cholecystitis tissue were collected as the control group. The level of expression of Shh and Foxm1 in the two groups was evaluated by SP immunohistochemical method, and the data was analyzed statiscally based on clinical pathological parameters.Results:1、Shh mainly expressed in cytoplasm. The expression of Shh in GBC tissue, cholecystitis tissue and normal tissue were 70.83%(51/72), 40.00%(21/30), 0.00%(0/15) respectively. It has statistically significantly difference between GBC tissue, cholecystitis tissue, and normal tissue(P<0.05); the expression of Shh in GBC group were closely related to histological grades, Nevin and TNM grades(P<0.05). But without relation to ages, sexuality(P>0.05).2、Foxm1 mainly expressed in plasma membrane. The expression of Foxm1 in GBC tissue, cholecystitis tissue and normal tissue were 77.78%(56/72)、35.00%(24/30), 0.00%(0/15) respectively. It has statistically significantly difference between GBC tissue, cholecystitis tissue, and normal tissue(P<0.05); the expression of Foxm1 in GBC group were closely related to histological grades, Nevin and TNM grades(P<0.05). But without relation to ages, sexuality,(P>0.05).4、Spearman correlation analysis showed a positive correlation between the expression of Shh and Foxm1 in GBC(r=0.392, P=0.001<0.01).Conclusion:1、The abnormal expression of Shh and Foxm1 were closely associated with the occurrence and development of GBC.2、Foxm1 was probably one of the Hedgehog signaling pathway downstream target genes.3、Combined detection of Shh and Foxm1 protein could help to evaluate the prognosis of GBC and provide theoretical basis for its treatment.Part 2 The different Expression of Shh in tumor tissue and normaltissue/adjacent tissue: a meta-analysisObjective: To study The different expression of Shh in tumor tissue and normal tissue.Methods: systematic review was conducted in Chinese database. The articles are before March 2015. We comprehensively searched electronic databases and manuscripts for randomized controlled trials(RCTs) and extracted data from eligible studies for meta-analysis. We have confirmed strict selection criteria in terms of types of participants, intervention types and methods to limit verification bias. We calculated the specificity, sensitivity, negative and positive predictive value of Shh overexpression. The results were displayed using forest plots and SROC.Results: Regarding to the possibility of using Shh as molecular target, there were 31 studies selected for meta-analysis. There were totally 2018 tumor samples, 578 samples of adjacent tissue and 584 samples of normal tissue. The Sensitivity of is 0.674[95%CI(0.653,0.695)], the Specificity is 0.792[95%CI(0.768,0.814)], the LR+ is: 3.270[95%CI(2.726,3.922)], the LR- is 0.398[95%CI(0.349,0.455)] in 32 studys. The area under SROC curve was 0.815.Conclusion: Owing to Shh overexpression in tumor tissues, the result of this research indicated that it would be developed as a molecular target for therapeutic method.Part 3 The different Expression of Foxm1 between tumor tissue and normal tissue/adjacent tissue: a meta-analysisObjective: To study The different expression of Foxm1 in tumor tissue and normal tissue.Methods: systematic review was conducted in Chinese database. The articles are before March 2015. We comprehensively searched electronic databases and manuscripts for randomized controlled trials(RCTs) and extracted data from eligible studies for meta-analysis. We have confirmed strict selection criteria in terms of types of participants, intervention types and methods to limit verification bias. We calculated the specificity, sensitivity, negative and positive predictive value of Foxm1 overexpression. The results were displayed using forest plots and SROC.Results: Regarding to the possibility of using Foxm1 as molecular target, there were 21 studies selected for meta-analysis. There were totally 1473 tumor samples, 478 samples of adjacent tissue and 340 samples of normal tissue. The Sensitivity of is 0.734[95%CI(0.711,0.756)], the Specificity is 0.822[95%CI(0.794,0.847)], the LR+ is: 4.168[95%CI(3.595,4.832)], the LR- is 0.313[95%CI(0.285,0.345)] in 21 studys. The area under SROC curve was 0.8578.Conclusion: Owing to Foxm1 overexpression in tumor tissues, the result of this research indicated that it would be developed as a molecular target for therapeutic method.